A Newer, Faster-Acting Insulin? (Faster than Novolog!)

A Newer, Faster-Acting Insulin? (Faster than Novolog!)

Diabetes Daily

A Newer, Faster-Acting Insulin? (Faster than Novolog!)

New findings from phase 3a trials show that a faster-acting insulin aspart by Novo Nordisk reduced A1c levels and improved after meal blood sugars in people with type 1 and 2 diabetes compared with NovoLog.

These findings were presented at the 76th annual Scientific Sessions of the American Diabetes Association (ADA) in New Orleans. Novolog (also marketed as Novorapid) is a fast-acting insulin aspart. The trial involves 2,100 people with type 1 and 2 diabetes and an even faster-acting insulin aspart.

The trial consisted of 26 weeks of randomized therapy using a faster-acting insulin aspart which showed statistically significantly improved A1c in adults with type 1 diabetes when dosed at mealtime compared with Novolog. A similar result in A1c improvement was found when the insulin aspart was dosed 20 minutes after a meal compared with Novolog.

What is Faster-Acting Insulin Aspart?

Faster-acting insulin aspart is a fast acting bolus or mealtime insulin in investigation stages developed by Novo Nordisk. It is also insulin aspart like Novolog (or Novorapid) but in a new formulation which includes a vitamin and an amino acid intended to increase the initial absorption rate and provide a faster and earlier blood sugar lowering effect. “Novo Nordisk has submitted the regulatory filing for faster-acting insulin aspart in the United States and in the European Union.”

How Did the Faster-Acting Insulin Aspart Work in Type 1 Diabetics?

The trial also showed a reduction in 2-hour PPG increment versus Novolog. In addition, 1-hour PPG increment was also reduced. The 2-hour PPG increment is the difference between the plasma glucose value at 120 minutes after a standard meal test and the fasting plasma glucose value. The 1-h PPG increment is the difference between the plasma glucose value at 60 minutes after a standard meal test and the fasting plasma glucose value.

How Did the Faster-Acting Insulin Aspart Work in Type 2 Diabetics?

The faster-acting insulin aspart also demonstrated non-inferiority in A1c reduction compared to Novolog in adults with type 2 diabetes. Non-inferiority means that the faster-acting insulin aspart was not worse than Novolog by a “small pre-specified amount”.

Trial results couldn’t confirm a statistically significant reduction in 2-hour PPG increment in type 2 diabetes but the faster-acting insulin aspart did show a statistically significant reduction in 1-hour PPG increment in adults with type 2 diabetes compared to Novolog.

Encouraging News for People Who Rely on Fast-Acting Insulin

Dr. Bruce Bode, onset 1 and 2 investigator, Diabetes Specialist and Clinical Associate Professor of Medicine at Emory University School of Medicine in Atlanta said, “We know that many people living with type 1 or type 2 diabetes may frequently struggle with spikes in blood glucose around mealtimes, resulting in post-meal hyperglycemia,” and that “The improvements in HbA1c and postprandial glucose control we see with faster-acting insulin aspart in the data from the onset 1 and onset 2 trials are encouraging.”

The most frequently reported adverse event with this faster-acting insulin aspart in type 1 and 2 diabetes was hypoglycemia (low blood sugar). There were no major differences in the rate of severe or confirmed low blood sugar episodes in people with type 1 and 2 diabetes compared with Novolog, however.

The press release from Novo Nordisk states that other common adverse effects included nasopharyngitis, upper respiratory tract infection, urinary tract infection, headache, nausea, diarrhea, and wrong drug administration and back pain.